This 5-year project is a randomized controlled trial of the TEA (Together for Empowerment Activities) intervention. TEA intervention is an innovative, theoretically-based, culturally sensitive family intervention for HIV-affected families in rural China. The intervention will have six sessions (plus a preparation session) delivered at three levels simultaneously: 1) TEA Gathering (small group for parents living with HIV (PLH) and their family members), 2) TEA Time (home-based family activities with children), and 3) TEA Garden (community events). Built on the extensive pilot work by the collaborative team in the past 5 years, we propose to conduct the randomized controlled trial of TEA intervention with 480 HIV-affected families in 24 villages in Anhui, China, including 480 PLH, 480 sero-negative family members, and 720 children aged 6-18. We will randomly assign villages to either: 1) TEA intervention group (with all three levels of activity), or 2) a control group (with limited activities). The efficacy the intervention will be determined over 24 months at five time points: baseline, 6, 12, 18, and 24 month follow-ups. The primary outcomes are children's physical health, mental health and behavioral adjustment. Secondary outcomes will be the PLH's and family members' physical health, mental health, and quality of life, as well as family indicators such as consistent daily routines, positive family interactions, parenting, coping, and community integration. PUBLIC HEALTH RELEVANCE: The need to respond to the HIV epidemic is a global public health priority. The proposed study responds to the urgent need for interventions for PLH, family members, and children impacted by HIV/AIDS in China. Resulting data will provide an evidence-based intervention that can be delivered to HIV-affected families in China and other countries.